902 



SCIENCE. 



[N. S. Vol. XXIII. No. 598. 



less should not be accepted. The casualty 

 companies, such as the Maryland, are the 

 worst offenders, and some concerted action 

 should be taken to compel them to mend 

 their evil ways. 



Lodge practise is another scheme by 

 which officers of an association draw 

 salaries ostensibly to give medical services 

 at a figure below the possible point at 

 which a professional man can live and con- 

 tinue his education. The people are badly 

 served, as competent physicians can not be 

 secured to do the work, and the whole 

 scheme is properly condemned by the 

 various medical associations all over the 

 country. 



Public service corporations abuse hos- 

 pital privileges in a way that is no more 

 or less than an open scandal. In Pittsburg 

 the steel companies pay $1 a day for the 

 care of their injured men at the hospitals 

 and for the class of patients under discus- 

 sion this can not be provided for less than 

 $1.60 per day. The companies pay the 

 surgeons at the hospitals absolutely noth- 

 ing for their services to its injured, which 

 amount to thousands of dollars a year. 

 The same conditions exist with many of the 

 large railroad and street-car companies and 

 other public corporations. 



Hospital abuse by patients who are able 

 to pay, through the neglect and indiffer- 

 ence of the trustees, is prevalent; and 

 thereby the profession is robbed of just re- 

 . turns for labor and the funds of charitable 

 persons misused to an extent which is al- 

 most beyond belief. All hospitals should 

 have competent individuals whose business 

 it is to see that no one secures free treat- 

 ment who is able to pay. 



Some great hospitals go still further and 

 receive any patient, rich or poor, allow him 

 to have a suite of rooms and bath and sev- 

 eral nurses if he can pay for the same ; but 

 will not allow him, even if he is willing to 

 do so, to pay the surgeon who operates 



upon, or the medical man who takes care 

 of, him. If the patient is disposed to be 

 more just than the trustees of the hospital, 

 he can do so only by giving a gratuity at 

 Christmas, as would be done with a servant. 

 Such indignity should be resented by every 

 right-feeling man. 



It is a misfortune that the large majority 

 of hospitals have no physicians among their 

 direct.ors. Hospital management is often 

 extravagant and wasteful, due to official 

 influence in furnishing comfortable berths 

 for incompetent relatives or i;nfortunate 

 friends in some salaried executive position. 



Fortunately, the list of grievances is not 

 large and I believe that they can be har- 

 moniously adjusted if taken up with the 

 proper authorities in a conciliatory spirit. 

 Our first object must be to see that no poor 

 person shall be subjected to the slightest 

 inconvenience or annoyance and that every 

 worthy charity shall have our united sup- 

 port; but we must look to it that the 

 charitable practitioner's time, knowledge 

 and skill shall not be misused. 



THE PRACTISE OF MEDICINE AS A BUSINESS. 



It is a hard matter to adjust the financial 

 side of the practise of medicine; that doc- 

 tors are poor collectors and bad investors 

 is a notorious fact and makes them the 

 easy prey of the various investment 'gold 

 bricks.' A physician owes it to himself, 

 to his family, to his profession and espe- 

 cially to the community at large, to man- 

 age his finances well. Otherwise he can 

 not pursue his studies and give to the sick 

 his best efl:orts which they have a right to 

 expect and demand. No sensible man en- 

 ters upon a medical career with a view of 

 making money. I have never known a 

 physician who has become x'ich solely from 

 this source, and it is better so; for beyond 

 that reasonable competence which leaves 

 him free to pursue his life work, the care 

 of money interferes with the highest aims 



